First night issues

Received my CPAP yesterday, a Puritan-Bennet Sandman Intro with integrated heated humidifier - and a Fisher Paykel Flexifit 407 Nasal mask. Woke up three times in the first four hours with a very bad case of dry mouth. I raised the humidifier temperature after the first time from 4-6, but it didn't seem to improve that much. Is this a humidifier issue or could I be mouth breathing - I didn't think I could mouth breathe because of the pressure.

I also had so minor soreness under my nose and ended up discontinuing use because of the soreness. I know this will get better as I get used to the mask, but am concerned about the dry mouth issue.

Any advice?

Welcome to the forum, BunkyBrice!

It would help us if you would fill out your equipment in your profile.

As far as dry mouth, if you haven't had it before, you certainly could be mouth breathing with a nasal mask. There are lots of threads about that very subject The fixes fall into several categories: 1) chin strap (a number of different varieties, none works for everyone), 2) Switch to a Full Face Mask (FFM) - doesn't work for everyone either, 3) Mouth taping - not "officially" sanctioned but nobody I've heard of has had a problem with this. This doesn't mean things like duct tape although I've heard of people using even that! There are many "gentler" methods of mouth taping which make it very fast and easy to remove in case you get sick during the night.

One way to verify mouth breathing would be to use the software to look at your leak rate. There will always be a certain amount of air leakage because the mask must clear the CO2. Excessive leak would indicate mouth breathing or a poorly fitting mask.

Sore nares often get better with time but there are some temporary solutions. Avoid anything with petroleum jelly since breathing those fumes can, in rare instances, result in lipoid pneumonia. My sleep doc suggested KY gel( ) and some people use lansinoh, etc.

Others will likely chime in to give you additional info and options.

Good luck!

Mindy

It is almost certain that you are mouthbreathing or mouthleaking. Time to move on to a full face mask. I just awoke from a wonderful dream sleep with the full face mask I have been using for nearly three years.

Here is something I wrote for newbies in another thread:

Newbies priority list

IMAO, here is a good progression:

1. Nasal pillows
2. Nasal pillows with chin strap
3. Full face mask

In step 1, you need to figure out as quickly as possible whether you can keep your mouth shut well enough to get a good therapy (I couldn't).

In step 2, you need to figure out if the chin strap will stop mouth leaks and if you can tolerate the dang uncomfortable strap (I failed both). You also need to check whether your cheeks puff out and awaken you over and over (mine did).

Step 3, move on to a ff mask and try several different models to find one that works for you.

Know that about 40% of patients mouthbreathe/leak and need a full face mask. If you are in that category, no need to bother with a nasal mask and get poor therapy.

Keep coming back here for advice; you will get a lot of advice here, some of it contradictory. Most people can wade through it and eventually get something that works for their case.

Regarding awakening with puffing out of cheeks with chin strap: I had that happen and it eventually disappeared. That may have occurred when I switched from Respironics M-Series to Sandman Auto (?).

If I could easily wear a FFM I would. I've tried a number of them but the silicone seal does a number on my rosacea despite REMzzz's and a special Padacheek cover (they do help some!). I can tolerate my Quattro for about 1 night once in awhile and yes, I do like it better and wish I could use it all of the time.

Mindy

Hello & Welcome, BunkyBryce! Glad you found this forum—SO much useful info and everyone here is so willing to help!

You're lucky to have found this forum as you begin CPAP--took me almost year before I found this place and, with the help of folks here, got my CPAP therapy working as it should. It does take time to get everything tweaked and working at its best, so patience is key as one begins CPAP.



"You are getting sleepy . . ."

I greatly appreciate the responses. I also post under BunkieBrice when I am upstairs and my computer prevents me from logging in.

I napped today and woke up mouth breathing and dry mouth, and this is definitely causing the cotton mouth. The good news is I dreamed last night and during my nap today, something I haven't done in ten years, so, in spite of the issues, I think I am sleeping better.

My energy is also much higher - I liken it to having a bigger gas tank. I don't feel like superman, but I feel good all day.

I wonder if I will learn to not breathe through my mouth. I like the mask I have and feel pretty comfortable with it - not sure I would feel the same way with a full face mask. I like to sleep on my side and my back.

My machine - Puritan Bennet Sandman Intro - apparently tracks only compliance information, so I am not able to get leak rates, etc...

If anyone has input on whether or not I can learn to not breathe through my mouth, which only happens when I sleep on my back, I would appreciate it.

Thanks again!

BunkieBrice wrote:If anyone has input on whether or not I can learn to not breathe through my mouth, which only happens when I sleep on my back, I would appreciate it.

Several people have posted being able to control their mouth breathing eventually. I seem to have improved mine to the point where I don't feel a major need for a FFM. I do use a chin strap --- have several, in fact.

Another thing - if you have something like a deviated septum in your nose, fixing that might be helpful in reducing mouth breathing. I recall some posts awhile back about training oneself to plant one's tongue behind the front teeth with the tip touching the roof of the mouth (hope I got that right!). I don't recall when or who but you could try some searches. I no longer wake up feeling like a chipmunk with air in my mouth

Mindy

mindy wrote:...rosacea...

I had rosacea several years ago for about 2 yrs...miserable experience; doc and I never figured out why it arrived nor why it went -- maybe something in the water? I used and still do DermaE's Alphalipoderm facial cream and their papaya-soy facial cleanser (like liquid soap & removes all makeup without drying out your skin). I also use their vitamin E serum (gel, no moisturizer) morning and night (only thing on face before the mask). I found that increasing omeaga 3s (fish oils) helped. Keeping my skin oil-free by washing 3 times a day (morning, after work, bedtime) and exfoliating the worse areas very, very gently really really helped. I've recommended this to 3 others who have rosacea and they've found them helpful; maybe you might too. I think DermaE has samples of all them, ck out their online site for their number.

With a FFM or nasal mask, it must really be a challenge! You have my sympathy.

Thanks much for the info - will check it out!!

Mindy

I have the same mask as you, only the petite version (F&P 406). It bothers my upper lip as well and puts pressure on my gums and teeth. I've started moving it higher between my eyes, which moves the bottom of the cushion to just under my nose. It feels much better, and leaks are less ... at least while I'm awake! Unfortunately I believe I'm starting to mouth-breathe as well, as the software shows my leak rate all over the place, and sometimes off the scale for a bit. This morning my mouth was dry as well, despite the heated humidifier. I just got a Quattro FFM off cpapauction and am waiting for it to arrive.

BunkieBrice wrote:......I wonder if I will learn to not breathe through my mouth. .......

Bunky,

Glad to hear you are feeling better that quickly.

I would pretty much echo what Mindy said. Some have claimed to learn to breathe through their mouth but my guess is they are the small exception. There are times when we need to breathe through our mouths. Just in the last two days the ozone levels here have gone up and my daily loratidine (generic Claritin) plus neti pot rinses has ceased to control some minor congestion at night. On these nights, I believe, without mouth breathing, I just would not get enough air through my nostrils and would not sleep well. I do use a full face mask, so my airway is kept open by the CPAP process during the parts of the night that I breathe through my mouth.

For anyone who has sleep-disordered breathing and breathes through the mouth for any period of time, I think it should be standard that they see an ENT. The ENT should perform an examination of the nasal airway and the larynx with a nasopharyngoscope, http://www.evmsent.org/examining_larynx.asp . This is an easy but valuable examination that is done in the doc's office in just a few minutes. The examination will reveal the condition of the septum, the turbinates, and the vocal cords. I had my turbinates resectioned and my septum corrected and the amount of mouthbreathing was greatly reduced but not entirely eliminated.

Good luck,